PATHOLOGICAL CRANIAL LESIONS IN A JUVENILE CRANIAL COLLECTION A Thesis submitted to the faculty of San Francisco State University in partial fulfillment of A - the Requirements for -i r the degree M2 Master of Arts In . IsA 53 Anthropology by Hannah Marie Miller San Francisco, California January 2018 Copyright By Hannah Marie Miller 2018 CERTIFICATION OF APPROVAL I certify that I have read Pathological Cranial Lesions in a Juvenile Cranial Collection by Hannah Marie Miller, and that in my opinion this work meets the criteria for approving a thesis submitted in partial fulfillment of the requests for the degree: Master of Arts in Anthropology at San Francisco State University. Cymhia Wilczak Associate Professor of Anthropology Associate Professor of Anthropology PATHOLOGICAL CRANIAL LESIONS IN A JUVENILE CRANIAL COLLECTION Hannah Marie Miller San Francisco, California 2018 The purpose of this study is to examine and analyze the age distributions and co-occurrence of endocranial and ectocranial lesions commonly associated with metabolic disease and inflammatory processes in juveniles. The pathogenic changes studied are porotic hyperostosis, cribra orbitalia and endocranial lesions. The specific etiology of any of these lesions remains uncertain. (Lewis 2004, Janovic et al. 2012, Walker et al. 2009, Wilczak and Zimova Hopkins 2010). While porotic hyperostosis and cribra orbitalia have been subject to multiple studies, to date no one has statistically confirmed a relationship between these lesions. Endocranial lesions have never been systematically studied in conjunction with porotic hyperostosis or cribra orbitalia. As Wilczak and Zimova Hopkins (2010) suggested that not all lesions classified as cribra orbitalia shared a common etiology, classification of porotic hyperostosis and cribra orbitalia were modified for analysis here. Endocranial lesions were classified according to type (Hershkovitz et al. 2002 and Lewis 2004). The co-occurrence of each type of documented lesion was examined with chi-square analysis using the Monte Carlo method to estimate p-values. Analysis found that while there is a statistically significant association between lesions commonly referred to as endocranial lesions and porotic hyperostosis (p= 0.03), there was not an association between porotic hyperostosis and cribra orbitalia (p= 0.2). This finding challenges two ideas that permeate the anthropological literature. First is the idea that there is not an association between endocranial lesions, porotic hyperostosis and cribra orbitalia. This study indicates that there is in fact an association between porotic hyperostosis and endocranial lesions. The results also suggest that not all lesions classified as porotic hyperostosis and cribra orbitalia have the same etiology. I certify that the Abstract is a correct representation of the content of this thesis. ACKNOWLEDGMENTS I would like to begin by thanking my thesis committee Cynthia Wilczak Ph.D. and Mark Griffin Ph.D who have guided me through this process. You both have helped refine ideas, re-work projects and have generally acted as sounding boards for the past few years. Having never failed to challenge and test me you have both made me a much better researcher and anthropologist. I would also like to thank Dawn Mulhern Ph.D., for introducing me to Biological Anthropology and beginning the process to make me an independent researcher. Thank you to Dorothy Dechant Ph.D. and Gary Richards Ph.D. who were absolutely invaluable to me during the data collection phase. To the staff of the SFSU NAGPRA program Jeff Fentress Ph.D. and Kathy Wallace, thank you for giving me the opportunity to work with you for the last few years and helping me to gain experience in an area which I still find immensely fascinating. Amanda Price and Chelsea Jordan, I don’t think I could have done this without you two there to talk me off the edge when I started to panic. Most of all I would like to thank my family who has never failed to support me throughout this process. DEDICATION For George Raymond Betz You were the one who first introduced me to Anthropology, and inspired my love of learning about others. You took the time to enquire about my classes and my research, even when the topic was not of particular interest to you. I will never forget sitting at your bedside and talking about the research for this project. Even at your most difficult time you were enthusiastic about this project, just because I was. I am only sorry you never had the opportunity to see the final results. v TABLE OF CONTENTS List of Table............................................................................................................................................................ v List o f F igures...................................................................................................................................................... vii List of Appendices.............................................................................................................................................viii Introduction..............................................................................................................................................................1 Literature Review...................................................................................................................................................8 Porotic Hyperostosis and Cribra Orbitalia....................................................................................... 8 The Early Works......................................................................................................................9 Introduction of Anemia........................................................................................................13 The Synergistic Approach................................................................................................... 16 Maize Dependency Models................................................................................................ 20 Revisiting the Early Works................................................................................................ 23 A Positive Adaptive Response......................................................................................... 28 Challenging Positive Adaptation......................................................................................29 Scurvy as a Cause of Porous Cranial Lesions..................................................................30 Porotic Hyperostosis as a non-specific indicator of stress...........................................32 The Iron Deficiency Anemia Etiology Challenged........................................................34 Co-occurrence of Porotic hyperostosis and Cribra orbitalia....................................... 36 Historical Scoring Methods............................................................................................... 37 Endocranial Lesions.............................................................................................................................38 Early Works........................................................................................................................... 38 SES and Intrathorasic Disease...........................................................................................39 Nonspecific endocranial lesions.......................................................................................41 Endocranial lesions and Scurvy........................................................................................ 43 Endocranial lesions and Trauma.......................................................................................44 Endocranial lesions and Infectious disease.................................................................... 45 M aterials.................................................................................................................................................................47 M ethods..................................................................................................................................................................49 Orbital lesions AKA Cribra Orbitalia.............................................................................................49 Cranial Vault Lesions AKA Porotic Hyperostosis......................................................................51 Endocranial lesions..............................................................................................................................54 R esults.....................................................................................................................................................................57 Porotic Hyperostosis and Cribra Orbitalia......................................................................57 Orbital Lesions and Endocranial Lesions.......................................................................62 Cranial Vault Lesions and Endocranial Lesions...........................................................63 D iscussion............................................................................................................................................................. 66 Conclusion............................................................................................................................................................ 70 Literature Cited ...................................................................................................................................................